Evidence map›Paper›PMID 41849604›Full record

ArticleScience advances2026

Applying machine learning to identify unrecognized COVID-19 deaths recorded as other causes of death in the United States.

Mathew V Kiang, Zehang Richard Li, Elizabeth Wrigley-Field, Rafeya V Raquib, Dielle J Lundberg, Eugenio Paglino, Benjamin Huynh, Kirsten Bibbins-Domingo, M Maria Glymour, Andrew C Stokes

Abstract read
In one paragraph

Article in Science advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mathew V KiangDepartment of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.ORCID 0000-0001-9198-150X
Zehang Richard LiDepartment of Statistics, University of California Santa Cruz, Santa Cruz, CA, USA.ORCID 0000-0001-9551-9638
Elizabeth Wrigley-FieldDepartment of Sociology and Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA.ORCID 0000-0003-3489-4279
Rafeya V RaquibDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.ORCID 0000-0002-0631-4081
Dielle J LundbergDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.ORCID 0000-0003-1494-4443
Eugenio PaglinoMax Planck - University of Helsinki Center for Social Inequalities in Population Health, Finland.ORCID 0000-0001-8733-6460
Benjamin HuynhDepartment of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA.ORCID 0000-0002-1372-7992
Kirsten Bibbins-DomingoDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.ORCID 0000-0002-8962-0622
M Maria GlymourDepartment of Epidemiology, Boston University School of Public Health, Boston, MA, USA.ORCID 0000-0001-9644-3081
Andrew C StokesDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.ORCID 0000-0002-8502-3636

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The actual number of US deaths caused by severe acute respiratory syndrome coronavirus 2 infection has been investigated and debated since the start of the COVID-19 pandemic. Here, we use machine learning trained on US death certificates from March 2020 to December 2021 to predict 155,536 (95% uncertainty interval: 150,062 to 161,112) unrecognized COVID-19 deaths. This indicates that 19% more COVID-19 deaths occurred in the US than officially reported. Predicted unrecognized COVID-19 deaths occurred disproportionately among decedents with less than a high school education; decedents identified as Hispanic, American Indian, Alaska Native, Asian, and/or Black; counties with lower household incomes and worse preexisting health; and counties in the South. These findings suggest that the US death investigation system undercounted COVID-19 deaths unevenly, hiding the true extent of inequities.

Indexed as

COVID-19Machine LearningCause of DeathDeath CertificatesHumansPredictive Learning ModelsSARS-CoV-2United States

Identifiers

PMID41849604
PMCPMC12998511

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.